Darwin/Garramilla, Larrakia Country

"There are some really amazing opportunities for us to grow."

As the Northern Territory’s first Chief Paramedic Officer - only the second such appointment in Australia and the second held by a woman, following in Dr Louise Reynolds’ footsteps as Victoria’s CPO - Shell Piercy is keen to embrace the many opportunities for progression and growth in paramedicine amid a landscape characterised by a sparse population and hundreds of remote communities and outstations.

For Shell, whose clinical career spans both paramedicine and nursing, it is the culmination of a long-held desire to help as many people as possible, which throughout the years has led her to take on increasingly greater challenges.

“I decided to take on bigger roles that would actually work at a strategic level to help more people, and I feel that's my driving force now. I love being a clinician. I love being a nurse and I love being a paramedic, and I love ambulances and I love working outside of ambulance services. But I understand that I can't help as many people as I want to in those roles, so the only way I can help is if I jump into these big, scary roles and make change.”

She said the Northern Territory was a region eager for innovative solutions and open to ideas, and one in which other health professions were willing to work collaboratively to usher in meaningful change.

“My vision is about where we're going. Paramedics aren't working out of an ambulance context at this point in the Northern Territory, so there are some really amazing opportunities for us to expand. There's lots to learn and a lot of systems for me to integrate into to make this happen. But this is a vast and remote territory with a unique population, where 30 percent are Aboriginal people. The region is seeing an increase in the prevalence of chronic disease, so if paramedics are going to make a mark here, it's definitely going to be in that space.”

Shell said there was a growing desire among paramedics to work in remote locations, and the Northern Territory offered professional development opportunities for those seeking to extend the scope of their clinical practice and utilise their skills in a unique environment.

“They want to be working in these remote locations, being able to use the education that they have, the critical care backgrounds, the extended care or community paramedic backgrounds, or are dual qualified.

“I think that's why the Northern Territory is going to be a really attractive place for people to work, and my vision is that we can better support really remote communities using these talented paramedics who are looking for the next opportunity, so I'm hopeful and excited. I don't see it as a massive challenge that I've come into; I think it's a good point for us to grow.”

She said her initial three-year tenure would be focused on building solid foundations for the profession, promoting greater understanding of paramedics’ capabilities, and guiding its integration into multidisciplinary healthcare teams. Rather than rush in with a raft of changes, she is opting for a more measured approach, building models of care around existing support mechanisms and legislative frameworks with a view to expanding those in the future. This is in line with the continued evolution of paramedicine both nationally and in the Northern Territory.

This also includes updating some of the terminology currently used in relation to paramedicine and key performance indicators, which reflects an outdated understanding of the nature of the profession. At present they’re reliant on quantitative, rather than qualitative, data, the number of hospital transports as opposed to the overall quality of patient-centred care.

“Some of the language needs to change in relation to quality of care and the measure of quality of care, and this is the most incredible environment for us to really make some big change. I think that’s where leaning on my nursing background and leaning on our nursing colleagues is really good because qualitative research is something that I didn't experience in my paramedic education as much as I did in my nursing education. The stories of people who are experiencing healthcare and their needs and outcomes as a result, they're only going to come through those qualitative means.”

The integration of paramedics into multidisciplinary healthcare teams is another priority in the coming years, with the involvement of paramedics in the planning, delivery and review phases a cornerstone of successful integration. As part of that process, she said it was important to promote a broader understanding of the differentiation between ambulance services and paramedicine as a diverse profession.

“One of my passions is making sure that the two are not synonymous. Ambulance services are ambulance services, and paramedics and paramedicine are quite different things. I can be a nurse, but you don't necessarily think of a hospital, and that's what I'm trying to do. I'm trying to make sure that when I say paramedic, people don't think of blue and red flashing lights.

“I think there's a real appetite for learning about paramedicine at the moment here in the Northern Territory and I'm working with people who talk about us at a strategic level. I'm under no illusion that we might not get everything we want to get done in three years, and I'm not going to pretend to have all the answers, because I don't, but I feel well supported by a community of people who also want to see change.

“There's a lot of work that's already been done in the Northern Territory prior to me arriving, so I'm really grateful to be working with an incredible team that is committed and on the same page. I think having an extended scope with well-grounded education and good governance are the basics and the core of what we need to be working towards.”